The Decline of Medical Dominance

Through this evolution, these pieces show the reader the concrete was that groups assured control through different methods of asserting authority. Since Starr wrote both of his chapters the evidence for how physicians finessed the healthcare system to their benefit through the use of authority is straightforward since he developed the language that is being used. However, when looking at Gambles chapter the evidence isn’t as clear. When looking at the creation of both the Providence Hospital and the Frederick Douglass Memorial Hospital both Dr. Williams and Dr. Mossell employed tactics to increased their authority over desired parties. As a starting point, both men used their limited societal authority at the time to further their education and become physicians (Gamble 16,20).

In the sociology of medicine Parson (1951) regarded medicine as functional in social terms. By tackling the person’s problems in medical terms the tendency towards deviance that was represented by ill health could be safely directed, until they could return to their normal self. (Lawrence 1994: p 64-65: BMJ 2004: Parson cited in Gabe, Bury & Elston 2006, p 127).

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

The core moral order of medicine in the United States shares many of the core values of the scientific community. Wendland describes four central ideas that she believes form this moral order. The first idea is “reductionist rationality,” or the idea that the body and its diseases can be understood in an objective and scientific way by reducing into smaller components. It implies that there is no need for a theological or mystical explanation to explain a biological process or disease that is not currently understood. The solution lies in future research. The second idea is “authority over

Unfair competition and socialism amongst physicians and medical students emerged as medicine advanced and health departments were formed. “Nurses in schools were resisted by physicians who would lose some patients if they were cared for at school--city (New York City Health Department) pointed out that they would gain more patients by referral--physicians prevented them from doing any significant medical care.” (Starr.) The demand for care increased as the use of checkups and health exams--insurance, job, school became more commonly used in day-to-day practice. Chapter 5 also introduced a new idea of germ theory, “in the first half of the nineteenth century, some authorities attributed epidemics to cotagonian and recommended quarantines-an ecomonically damaging measure.”

It can be a positive or negative effect, having and using power depending on how it is controlled by the individual. Positive effect is to facilitate treatment and negative is preventing access to services, due to pre-existing conditions such as mental health. Power and control operate on varying levels and service users may recognise that the professionals due to their knowledge and expertise have the power. Social and cultural expectations can affect balance of power in health. Peterson and Bunton stated that there was a desire to identify, control and eliminate disease’ (2000, pg 9). In conjunction with the growth of medicine and science came the medical model. This approach focuses on the individual having dysfunction and treating identified health issues. Welshman suggested it was created to respond to socially upsetting or disruptive phenomena’ (2006, pg 9). The

As countries transition from a subsistence economy to an industrialized economy, they begin to gain access to more resources that are essential for providing a long, healthy life for their citizens. The United States and the United Kingdom are both developed countries that have large populations. They both have excellent medical systems, however, they are structured slightly different. In An “Insider’s view of the American and UK Medical Systems” Jennifer S. Marsden, a family doctor from Alabama, addresses doctors to juxtapose the US and UK medical systems by incisively breaking down the few differences of the healthcare structure of both countries.

In the world that we live in today, many people would find it difficult to imagine living in a world where medicine and treatment are not readily available. The replacement of religious explanations to medical and scientific explanations has become a means of social control. If a person is in pain, they can easily set up an appointment with a doctor and receive some sort of medical diagnosis. However, there are certain instances where a problem has not been medicalized, or recognized as a medical problem, and their issue will be dismissed completely. The movie One Flew Over the Cuckoo’s Nest delves into the idea of medicalization and how it can be used for the good, or for the bad, in terms of the “sick role.” Medicalization in the

physics of birth; moving from sitting and squatting, which was used historically by midwives and

This risk does not reflect a judgment that physicians are more prejudiced or influenced by race and class than the rest of society. Also, they are not exempt from the prejudices manifest in other areas of our collective life. While our society aspires to eradicate discrimination and the most punishing effects of poverty in employment practices, housing, education, and law enforcement, we consistently fall short of our goals. The costs of this failure with assisted suicide and euthanasia would be extreme. Nor is there any reason to believe that the practices, whatever safeguards are erected, will be unaffected by the broader social and medical context in which they will be operating.

Medicalization, a concept developed by sociologist Irving Zola in the 1970s can be understood as an expansion of professional power over wider spheres of life, especially deviant behaviors, replacing religious and legal enforcers and their roles of social control. As medical professionals continually enlarge their jurisdiction, societal resources devoted to activities assumed by physicians also increase and physicians become gatekeepers for an ever-expanding number of social functions (Crawford, 1980). Irving Zola argues that medicalization in this sense is connected to the control of medical professionals and their tendency to generalize their expertise beyond technical matters (Zola, 1977). Medicalization also refers to the extension of the range of social phenomena mediated by the concepts of health and illness, often focusing on the importance of that process for understanding the social control of deviance (Crawford, 1980). Through medicalization, deviant behavior becomes defined in terms of sickness, and normalcy becomes defined in terms of health rather than social factors. Alcoholism, opiate addiction, obesity, problems with sexual functioning, and violence have all become matters for medical diagnosis. As a result of medicalization, our society has become increasingly concerned with disease prevention and health promotion, with more social activity being thought about in their relation to health. This results in mundane behaviours such as eating, drinking, working, and other leisure activities being judged, as prevention of illness becomes more spread out.

This essay will discuss about the medical dominance, how power and hierarchy have influence on both patient and medical professionals in the Australian health care system, especially in the field of midwifery. The general concepts of power and the hierarchy in health care setting and how it has closely interwoven with the health sociology would be investigated throughout the essay. The social determinants of health in terms of social justice and equality, moreover, are significant factors in accessing appropriate health service and achieving better health outcome with the patient. It would also utilise the conflict theory to illustrate historical, structural, cultural and critical factors on supporting the power structure, agencies related

The conceptualisation of medicine as an institution of societal control was first theorised by Parsons (1951), and from this stemmed the notion of the deviant termed illness in which the “sick role” was a legitimised condition. The societal reaction and perspective was deemed a pillar of the emerging social construction of disease and conception of the formalised medical model of disease. Concerns surrounding medicalisation fundamentally stem from the fusion of social and medical concerns wherein the lines between the two are gradually blurred and the the social consequences of the proliferation of disease diagnosis that results from such ambiguities of the social medical model.

The social sciences became so pervasive in the twentieth century they not only produced new additions to medical discourse, but completely shifted the means of enforcing power. The emergence of individualism and the importance that was placed on one's essential and core identity made it so power that was once externally imposed by physical punishment only, began to enforce itself by way of the individual. The internalization of surveillance, domination, and discipline created a society of self policing individuals. This self policing behavior is most evident among women, and unlike the bodily protest against domestic expectations and other inequalities; it is the internalization of these oppressions, however ultimately manifesting as illness

Imagine you are injured or sick and have sought a doctor’s help. Although you trusted your doctor, something, something seemingly very in control of the doctor, went wrong. You are angry and confused, but also think of the commonality of medical malpractice. So, why do doctors, who are supposed to help, harm? Though many flaws influence it, malpractice can be, and often is unintentional. Most doctors aren’t trained to harm their patients. Inexperience and lack of medical discovery led to unintentional suffering of the patient. Personal flaws, like lack of willingness to abandon previous medical methods and shortcomings in communication also harm patients. Further reasons why doctors harm are socio-medical understandings that breed hate, prejudices stemming from a society’s belief about certain people, such as the medical practice under the Nazi regime. Additionally, displayed in the case of Ignác Semmelweis, judgement of one to oneself can be detrimental to any progress one’s ideas could make. We will examine these concepts through Jerome Groopman’s “Flesh-and-Blood Decision Making”, Sherwin Nuland’s The Doctors’ Plague and Barbara Bachrach’s “In the Name of Public Health”. Those who practice medicine are, unfortunately, unfree from the imperfections that plague all of humanity. Through these intimate and varied faults, doctors do harm.